Washington Wire

On October 7, the House passed monumental bipartisan managed care reform legislation. Known as the Dingell-Norwood bill, HR 2723, the Bipartisan Consensus Managed Care Improvement Act of 1999 passed by a significant margin of 275-151. While the House leadership offered several substitutes in an attempt to derail the reforms, all such amendments failed and the underlying bill passed. If signed into law, millions of Americans would be empowered to hold HMOs accountable for their medical decisions. The House bill covers 161 million people and enables patients to sue HMOs for substandard care, while the Senate version applies to only 48 million and has no such liability provisions. Both bills prohibit HMOs from interfering with a doctor’s right to discuss all treatment options with a patient. The differences in the House and Senate bills will be ironed out in conference committee. Prior to passage of the managed care legislation, the House passed a separate package of health-related tax provisions including Medical Savings Accounts. This bill was later merged with the managed care reform bill. While I am skeptical of some of these unproven tax incentives, I support the overall bill in the hope that the final version will maintain as many patient protections as possible.

As the end of the fiscal year passed, Congress gave itself additional time to complete its work on appropriations by passing a Continuing Resolution, which effectively extended the fiscal year for three weeks. Of the thirteen appropriations bills, only five have been sent to the president. The president has signed four and vetoed one. Several controversial elements in the appropriations bills have contributed to the delay in the budgetary process. The widespread use of budgetary gimmicks by the Congressional leadership has also contributed to the appropriations hold up. For instance, the leadership has proposed to extend the fiscal year by a month and change the way the Earned Income Tax Credit is paid to lower income earners. This alone would adversely affect millions of working families. As education remains one of my top priorities, I will be working this week to ensure that funding for Head Start, Pell grants, Title I funding for disadvantaged students, and funding for special education are secured during consideration of the Labor-HHS-Education appropriations bill. I will keep you posted on any developments during this difficult process.